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The more I do this–this writing/activism/therapy thing that I do–the more I’m coming to believe that there is almost never anything to be gained by telling people how to feel, or how not to feel.

In fact, I worry that doing so is at best neutral, probably manipulative, possibly cruel, and at worst abusive.

The most obvious examples provoke little disagreement from the social circles I move in–for instance, telling a person with depression to “cheer up,” telling a person with anxiety to “calm down,” telling a person who is angry to “stop being so angry,” telling a person who has suffered trauma to “just get over it.” These are all examples of telling people how to feel, or how not to feel, that most of us would recognize as wrong.

But the message that folks seem to get when we talk about this isn’t “telling people how (not) to feel is wrong,” but rather, “don’t tell people with mental illness/trauma history to get better because they can’t just do that on the spot.”

But what if they could? What if the cause of the emotions was something other than mental illness or trauma? Then would it be acceptable to tell them how to feel?

I think some people would say yes, at least in certain situations.

Emotions and morality are all bound up in our minds. We associate certain emotions with certain moral acts and other emotions with certain immoral acts (which with which may depend on one’s social group). Although there may be a correlation, of course, it’s probably not nearly as strong as people assume. Moreover, it’s much easier, in my experience, to change your behavior than to change your emotions. Even if you are neurotypical, but especially if you are not.

So we start to point to certain emotions, which we consider “markers” of certain immoral acts, as the problem. It’s wrong to feel angry or resentful when a potential romantic partner turns you down. It’s wrong not to be angry about injustice. It’s wrong to feel happy during a time when other people are sad. It’s wrong to fail to feel sad when Objectively Sad Things (like the loss of a loved one) happen.

I would argue that none of those are actually wrong, though. It’s wrong to guilt-trip, manipulate, or punish someone who doesn’t want to date you. It’s wrong to do absolutely nothing to make the world a better place despite having the ability to do so. But you can feel resentful at someone who rejected you without ever mistreating them, and you can actively make the world a better place without ever feeling angry about injustice.

It’s ironic that we use emotions as a proxy for actions when they are so much more difficult to change. You can change them, of course, but only with time and effort, and almost never right in the moment. Happiness is pretty easy to kill, as I was reminded very directly after Obergefell v Hodges came down, but it’s rarely replaced with the feelings that were intended to replace it. When people kept suggesting that anyone who feels happy after that decision is a terrible person who doesn’t care about other issues and naively believes that The Fight Is Over, I wasn’t suddenly full of fiery anger on behalf of all the LGBTQ folks who continue to face marginalization (including, by the way, myself). I just felt sad and defeated, and very condescended to.

More importantly, though, I worry about the ramifications of assuming that we can and should tell people how to feel. If you tell someone to calm down or cheer up or get angry and they immediately comply, I’m not sure that that’s a healthy process. I’m not sure that it’s ultimately a good thing if people are able to change their emotions (or convincingly pretend to) as soon as someone demands it. To me, that sounds more like an abusive situation than anything else.

I’m also concerned because, once you learn (as many of us do at some point or another) that others are better than us at knowing what our emotions ought to be, that process of adjusting your emotions (or emotional expressions) to their expectations becomes par for the course. Certainly someone can claim that their particular reason for telling you how to feel is Very Important and For A Good Cause, but everyone claims that, including abusive people. Many people in my life could say that it’d be For My Own Good if I could just stop feeling sad on command. Many people have a vested interest in keeping us from being angry, or expressing our anger. Once you get in the habit of “correcting” your emotions at others’ request, it’s going to be, well, a habit.

Moreover, when people believe that it’s their emotions, and not their actions, that are problematic, they often try to push away and suppress those emotions because they are Wrong. They may even succeed for a while, but ultimately, this sort of project inevitably fails. (I’ve been there.) Suppressing Wrong emotions prevents self-awareness, which is exactly what you need to make sure that you don’t hurt people because of your emotions. Telling people their emotions are Wrong is not only ineffective, but counterproductive.

You might think that if you tell someone that their emotions are Wrong, they will immediately say, “Wow, you’re right, I will call a therapist and set up an appointment right away.” Wouldn’t that be nice. But that’s not how it works. Even if there’s a strong indication that someone probably needs to go to therapy, if you stigmatize them that way, they’ll probably believe that 1) the therapist would stigmatize them that way too, and 2) they’re a terrible person who doesn’t deserve help.

Unfortunately, I notice this a lot in people who are trying to figure out how to deal with romantic rejection, especially men. They hear that people (especially men) who get upset when they’re rejected do terrible things, and they hear that feeling upset is as much a problem as the actual doing of the terrible things. And I get that the message gets diluted a lot when we’re trying to deal with horrific shit like Elliot Rodger, but thankfully, the vast majority of people are not Elliot Rodger. Feeling upset or even angry when you get rejected is normal. You can work on it with a therapist (or with some helpful onlineadvice) if you want, but what matters is how you act. That’s what makes you who you are.

What about emotions that are Truly Awful? What if someone is disgusted by trans* people? What if someone is terrified when they see a Black man approaching on the street?

To be honest, I don’t really know what to do with these emotions (and I’m perfectly willing to admit that I don’t know). Here people can make a convincing argument that these emotions actually do lead to actual harm done to marginalized people, which is true. Here, again, the problem is the actual harm done to these people and not what goes on in someone’s head, but what goes on in someone’s head is undeniably related to the actual harm done to these people!

Then again, these emotions don’t come from nowhere. They, like many emotions, come from thoughts or ideas. Those thoughts or ideas are, “People ought to be either Men or Women” (where “Men” or “Women” means “as traditionally defined by cissexist assumptions), “Black men are dangerous,” and so on. There’s no use in telling people not to be disgusted by trans* people and not to be afraid of Black men unless we address the ideas that are prompting those feelings. As someone who has experienced lots of such shifts in feelings over time as my understanding of power, privilege, and oppression has evolved, I can attest to this.

In sum, I don’t have all the answers on this, but I’m starting to believe that it doesn’t really do any good to police people’s feelings, even when they seem like the wrong feelings.

Kate recently wrote about how sometimes, viewing your emotions as unjustified or irrational can actually prevent you from taking action to make them better. On the other hand, simply accepting all emotions as “valid” can also leave you with no way of trying to change them. To try to resolve this issue, she proposes a distinction between “local validity” and “global validity”:

Local validity is about noticing and responding to your current emotions as if they’re real emotions that are happening to you. Global validity is about reflecting about the trends and patterns of emotions and how well you think they’re grounded in a realistic view of the world.

Irrational and invalid aren’t the same thing. We can go wrong when we believe that any emotion that’s irrational must therefore be invalid, but we also go wrong when we believe that any emotion that’s valid must also be rational. (I think the latter error is made less often, but it’s true that some people feel that because emotions are “valid,” they must simply accept them as they are.)

In social circles where rationality is very highly valued, it can become difficult to tell others about how you’re feeling when you think that your feelings are irrational. Sometimes we fear judgmental responses from others (“But that makes no sense! Of course I don’t hate you! How could you possibly believe something like that?”). Other times, we may trust that people will be supportive, but we still don’t want to come across as someone who has a lot of “silly” or “irrational” feelings.

In this way, sometimes, people in social circles that have more traditional approaches to relationships and communication are at a slight advantage. For instance, suppose Sally is in a traditional monogamous relationship with Bob. Sally might feel totally comfortable telling Bob that she’s jealous when Bob spends time with his friend Susie. Sally might even feel comfortable expressing anger about this.

Of course, the resulting conversation might not necessarily be productive–Bob might just agree not to spend time with Susie anymore, or he might react angrily and tell Sally that she’s being “crazy.” But in my social circles, we often wouldn’t express feelings like Sally’s at all. We feel that being progressive/feminist/polyamorous/rational/whatever means we shouldn’t feel jealous when a partner spends time with a friend (or another partner), because that’s irrational, and therefore that feeling should be ignored rather than brought out into the open.

And so a lot of us end up trying to ignore or cope with these feelings alone. Where Bob might hug or kiss Sally and reassure her that he loves her, we get ice cream and Netflix. (Or maybe that’s just me. Seriously, I am Extremely Bad at this.)

The difference is that many people in traditional monogamous relationships treat jealousy as normal, even healthy, even a sign that you really love someone. Expressing jealousy in the context of these relationships can be a completely acceptable thing, like telling your partner that you’re annoyed that they didn’t tell you they’d be home late, or that you’re sad that they can’t spend the holidays with you and your family. I don’t want to borrow traditional monogamous folks’ ideas about jealousy necessarily, but I want to borrow their norms about expressing it and expecting your partner to hear you and respond lovingly to you even if the jealousy is “irrational.” (Yes, yes, #notallmonos.)

But as Kate’s example shows, this tendency to conflate “irrational” and “invalid” doesn’t just apply to relationships and decisions about whether or not to tell others how we’re feeling. I have a hard time engaging in self-care practices that help if I don’t feel like there’s a “rational” reason to feel the way I’m feeling.

For instance, if someone was mean to me or I had an awful day at work, I acknowledge those as “good” reasons to feel bad, and in response, I might ask friends for support or spend some money on something that brings me joy.

But if I’m feeling bad for reasons I think aren’t “good,” such as being jealous of someone or completely randomly, then I don’t feel like I have the “right” to ask for support. I don’t feel like it’d be justified to take time off of my responsibilities to do something pleasant to improve my mood. So I just sit there and suffer through it.

In a blog post, Malcolm writes about how it can be useful to “step outside” of one’s own feelings. To help someone else do that, you might ask them, “What feelings came up for you during that?” rather than “How do/did you feel?” The latter question makes people identify with a feeling in ways that the former doesn’t. To say that sad feelings came up for me feels different than saying that I am (or was) sad. He adds:

Our sociolinguistic context is full of maxims like “that’s just how I feel” or “I can’t help how I feel” or [INSERT OTHER EXAMPLES]. We don’t necessarily take them seriously, but they add to the confusion of what someone might mean when they say “I feel X”. A bunch of questions you could (mentally or verbally) ask in response:

do you endorse feeling X? do you think that feeling X makes sense?

would you like me to address (my reassurance, etc) towards the feeling, towards its causes, or towards you as the experiencer of the feeling?

is that all you’re feeling?

how do you feel about having that feeling?

do you see a way out of the feeling or does it feel all-consuming or inevitable?

Questions like these, when asked of yourself, can make it a lot easier to communicate feelings that you think are irrational. For instance: “I don’t endorse this feeling, but I’m jealous about your date with ____.” “I know this doesn’t make sense, but I’m sad about leaving for vacation tomorrow.”

And on the flip side, when people share feelings like these with us, I think it’s important not to jump too immediately to “Your feelings are valid” or “It’s okay to feel that way.” Those are very important and worthy sentiments, but for many people (such as me), they can contribute to a defeatist sort of attitude: “Well, I guess it’s ok that I’m just going to feel depressed every time a friend succeeds at something I haven’t, since that’s a valid and okay way to feel.” Often, “valid” starts to mean “unchangeable.”

Here, Malcolm’s example question, “How do you feel about having that feeling?” can be very helpful. If someone says they’re ashamed or embarrassed or having difficulty accepting that this feeling is even happening, validation can be very helpful. But if they say they’re frustrated by having to deal with the feeling, or they understand where it’s coming from but still wish it weren’t happening, then validation can unintentionally send the message that they should just accept it.

Some of this, I think, is a question of where someone is in their own process. Years ago, I was unable to fully acknowledge my depressive feelings because I didn’t understand that I had depression, and kept trying to convince myself that I “should” be happy given all the good things I had going for me. At that point, if someone had told me that sadness/depression is a valid feeling, that might’ve been a revelation.

Nowadays, I’ve basically accepted the fact that I have depression and that that brings with it depressive feelings. At this point, reminders that my feelings are “valid” are pretty much useless. I want to change them! And in order to change them, I have to understand how they’re irrational, how they’re set off, how to counter those automatic processes, and basically how to tell myself a better story about my life.

Ironically, both of these counterproductive processes can happen for the same person. Sometimes I refuse to treat my feelings as valid simply because they’re irrational. Other times, I have trouble changing irrational feelings simply because I’ve accepted that they’re valid. Depression feels so real that changing it seems impossible. But it’s not.

~~~

Note that I intentionally avoided getting bogged down in what exactly “rational” and “irrational” and “valid” and “invalid” mean. If this post doesn’t make sense to you, we’re probably working from different definitions, and that’s okay. Another blog post, another day.

It’s a rare relationship that doesn’t require any boundary setting, and the therapeutic relationship is no exception.

Setting boundaries is something many people find difficult for all sorts of reasons–fear of rejection, uncertainty over whether or not your desired boundaries are legitimate (spoiler alert: they are), a history of getting bad reactions from people when setting boundaries with them, and so on.

It’s especially difficult to set boundaries with people you perceive as having more power than you, whether they actually do or not. Therapists are often perceived as having power over their clients because of their expertise and authority, and because it can feel like your therapist is holding your mental wellbeing in their hands. Sometimes that power is more tangible–for instance, in cases where counseling is mandated or when the client needs their therapist to sign off on or approve something. And sometimes that power is compounded by structural factors, like when a client of color works with a white therapist or a queer client works with a straight therapist.

Although these power differentials are real and have consequences, it might be helpful to reframe the client-therapist relationship slightly. Namely: you, as a client, are employing your therapist. Your therapist works for you. Most likely, either you or your insurance company (or both) are paying this therapist, not the other way around. If your therapist isn’t helping you, or is doing something that you find harmful, you have a right to let them know and to expect them to fix the problem. You can fire a therapist who is failing to help you just as you can fire anyone else you hired for some task or service that wasn’t done to your satisfaction.

Some therapists may reject this framing because it feels too consumer-y, or because they worry that this will cause clients to leave them. But I would argue that we shouldn’t be using social norms to trap clients in therapeutic relationships that aren’t working for them, and also, this framing is directed more at clients than at therapists, because I think it will help them feel a greater sense of control over their therapy.

How to know when you need to set a boundary

Therapy can be uncomfortable sometimes. But it should be uncomfortable in ways that mesh with your goals. For instance, if your goal is to learn how to ride a motorcycle, but you’re scared of riding motorcycles, you’re going to be rather uncomfortable. That’s normal and okay. However, if your goal is to learn how to drive a car, and someone is pressuring you to ride a motorcycle instead, that’s not a normal and okay sort of discomfort.

If your goal is to form healthier, more stable relationships with others, you might be uncomfortable when your therapist notes that you seem to assume negative things about people without evidence. You may disagree with your therapist’s observation, at least at first. You may even be right. You may think, “How dare they tell me I assume the worst of people!” But that discomfort is part of the process. Even if your therapist’s observation turns out to be wrong, both of you have gained from this. You’ve gained greater understanding of you. But if your therapist’s observation turns out to be right, then you’ve especially gained.

On the other hand, if your goal is to form healthier, more stable relationships with others, and your therapist suggests that maybe it would help if you accepted Jesus into your life, the discomfort you may feel (at least if you don’t already believe in Jesus) is not part of the process. You and your therapist are at cross purposes. You have already decided that Jesus is not for you.

Not all examples of boundary-crossing are that obvious, however. Many people who go to therapy to deal with trauma report that therapists ask them invasive questions about the trauma, questions that they’re not ready to answer before more trust is built or before they work through things a little more. However, some therapists were trained that they should push for details about traumatic events because talking it all through in detail helps people heal. This theory has since been complicated quite a bit.

Even if sharing all the details of a traumatic event necessarily helped people heal, though, it is crucial that therapists understand that just because the therapy office should be a space where clients feel comfortable sharing anything, that doesn’t mean it automatically is. It can be triggering for survivors of trauma to reveal intimate details about what they went through to someone who is still basically a stranger to them. It’s perfectly legitimate for them to shut down certain avenues of questioning and to expect therapists to respect that boundary until they are ready to shift it.

Setting a boundary vs. firing

When do you ask a therapist to stop doing something that isn’t ok with you, and when do you simply stop seeing them? In most cases, the answer probably depends on what happens when you try to set a boundary. If your therapist refuses to respect your boundary or argues with it, it might be a good idea to find a different one.

(Note, though, that they might agree to respect your boundary but still ask you questions about the boundary itself. While this can feel uncomfortable, I think that’s usually that better kind of uncomfortable–your therapist needs to understand you and your boundaries in order to be able to help you, and it may also help you to process your reasons for needing the boundary.

For instance, when a client says that they can’t talk about something [yet], I won’t push them to talk about it. Instead, I might say, “How do you feel when you imagine telling me about this?” or “What happened last time you tried to talk about this with someone?” That yields a lot more information than “I really think you should tell me,” and is more compassionate.)

Another way to tell whether to boundary-set or leave is this: think about what it would take for this situation to be okay. For instance, suppose your therapist mentions that attending church might be a helpful way for you to cope with depression because that’s what helped the therapist. This makes you feel really uncomfortable and you don’t want to hear anything else about the supposed benefits of religious observance from your therapist. Imagine you say, “Please don’t mention religion to me anymore; I’m not religious and am absolutely not interested in attending church or hearing anything else about church.” Imagine your therapist responds, “Okay, absolutely. I won’t mention it again.” Does this feel okay to you? Are you okay continuing to open up to someone who might believe that you’d do better if you went to church (but doesn’t say so out loud), or are you still uncomfortable?

If you continue to feel uncomfortable no matter how well the therapist responds to your boundary-setting, then you might need to find a new therapist. The strength of the relationship between a client and therapist is the best predictor of the effectiveness of the therapy, so if you can’t trust or feel comfortable with your therapist, they’re unlikely to be able to help you.

Scripts for setting boundaries

In many ways, setting boundaries with a therapist doesn’t work much differently from setting boundaries with other people. Just as I might ask my friends not to talk about weight loss around me, I might ask my therapist not to mention weight loss in therapy. Just as I might ask a partner not to ask me about [topic], I might ask a therapist not to ask me about [topic].

One difference, though, is that it might be really useful in therapeutic boundary-setting to explain why you’re setting that boundary. With other people in our lives, that’s not always necessary and may be too scary/risky–I don’t want to disclose my history of disordered eating every time I ask someone not to talk about weight loss with me. Your boundaries are your boundaries whether your reason for them is one that others would consider “legitimate” or not. (All boundaries are legitimate.)

But a therapy situation, telling your therapist why you need this boundary gives them useful information that will allow them to help you better. If you say “please don’t mention weight loss because I have a history of harmful behaviors around that,” they might know what else not to mention, or what to ask for permission before mentioning. Knowing that you have a history of harmful weight loss behaviors helps them understand your psychological history and know what to look out for in the future.

Here are some specific examples of ways you can set boundaries with a therapist:

“Please do not ask me about my weight or dietary habits. It’s a trigger for me because of past issues with disordered eating.”

“Actually, I didn’t ask for advice. Please either ask me before you give advice, or wait for me to ask for it myself.”

“The issue I came here to work on was my depression, not my relationship with my parents. Let’s keep our discussion focused on my depression as it’s affecting me right now, because that’s what’s causing the most problems for me right now.”

“I’m not ready to talk about the stuff that happened with my brother when I was little. You can ask me again in a few weeks and I’ll let you know if I’m able to talk about it then.”

“My identity as an atheist is not the reason I’m struggling with depression. If you continue to suggest that my mental illness is caused by atheism, I won’t feel comfortable coming here anymore.”

“I do not believe in karma, Zodiac signs, or any other superstitions. Please stop bringing them up in our sessions and stick with what can be tested scientifically.”

“I need you to stop suggesting that it’s my fault that I’m being bullied. Even if there were some truth to that, it feels like you’re putting all the blame on me and it’s preventing me from opening up to you about things.”

It may feel somehow manipulative to tell a therapist that you won’t tell them things or come back to therapy if they don’t respect your boundaries, but it’s also true. You can’t effectively work with a therapist you can’t trust, and they need to know that.

Also, while I certainly don’t think you should be intentionally mean, don’t worry about the therapist’s feelings. It’s our job to worry about our feelings, and your job to be as direct and open with us as you can be.

When setting boundaries is a challenge

As I mentioned, most people find boundary-setting difficult, especially in situations where they feel that they have less power than the other person. If you’re finding it so difficult to set boundaries with a therapist that you’re unable to speak up about it at all, here are some suggestions:

Practice first. You can practice in front of a mirror, alone in the dark, with a friend–whatever works for you. If you’re practicing with a friend, you can tell them a little about your therapist and what they’ve been doing that’s problematic so that they can roleplay as the therapist. Make sure to be clear with your friend about what you want them to do in the roleplay–for some people, roleplaying “worst case scenarios” (for instance, your therapist arguing with you and refusing to respect your boundary) can be useful because it allows them to prepare; for others, it might just be really anxiety-provoking.

Write it down and bring it to session. If you don’t feel like you can come up with the right words on the spot, write them down and bring them to therapy with you so you can read them or at least refer to them. It might sound weird, but you won’t be the first person who’s done it. Many therapists actually encourage clients to do things like this, because anything that helps facilitate communication in therapy is probably a good thing.

Write it down and email it. Although we often hear about the virtues of Real Face-To-Face Communication, I’d say two things here: 1) text-based communication is also a real and legitimate way to discuss difficult things, and 2) the perfect is the enemy of the good. If you are so uncomfortable bringing something up with your therapist in a session that you’re not going to bring it up at all, try doing the next best thing, which is emailing them. That way, you’ll have ample time to think about what to say and run it by trusted people if you want to. Know that your therapist may respond by asking you to bring this up with them in the next session, so you’ll probably still need to discuss it with them in person, but that initial email can help open the floodgates.

Be transparent with your therapist. You can say something like, “Setting boundaries is really hard for me, so I’m having trouble finding the words for what I’m trying to say,” or “I’m really uncomfortable with something you said in the last session, but I’m scared of bringing it up.” A good therapist will know how to guide you through this and help you speak up.

Don’t worry about bringing things up days or weeks after the fact. You don’t have to have a perfect, firm, concise boundary-setting comeback right away. It’s totally normal in therapy to bring up things that happened a few sessions back. It’s never too late to make sure that therapy is meeting your needs.

Conclusion

Sometimes all people need to hear to be able to set boundaries with their therapists is that they have the right to. Always remember that. Your therapist works for you. Your therapist has expertise, yes, but they are not the expert on you individually. You know way more about yourself and the boundaries you need than any therapist can ever know.

It is true that some of the boundaries you may set may delay your growth or recovery, or make it more difficult for your therapist to understand what’s going on with you. However, what delays your growth or recovery even more is feeling unable to trust your therapist or connect with them. A boundary isn’t a permanent brick wall. It’s a fence. Two people can stand and chat from opposite sides of a fence, and over time, you can choose to build a gate in the fence and open it up, or close it again.

After having written tons of postsaboutsupportingpeoplewithmentalillness, I realized that there was a gap–I’ve seen few articles about how to reach out for support when you’re the one with the mental illness. Specifically, how to do so in a way that’s respectful of people’s boundaries.

This is a difficult topic, for reasons that I think are obvious. I don’t want to discourage anyone from reaching out for help, ever. I also want to encourage people to be mindful of others’ needs and boundaries, even when everything hurts so much that that feels impossible to do. Especially then.

Why do these two goals feel like they stand opposed to each other? They shouldn’t. Getting affirmative consent before sharing difficult and potentially-triggering things with people isn’t just good for them, it’s also good for you. Most of us who struggle with mental illness have our moments of panic about imposing on others or being a burden on them. Making sure that we’re actually getting their consent before leaning on them for support can help us with those feelings.

I’ve been on both sides of this. I’ve been the depressed and suicidal person who had to reach out for help, sometimes in ways that didn’t really allow people to say no. I’ve also had people reach out to me in ways that made me feel trapped and coerced. So I think I have a lot of empathy for everyone in both of these situations.

This is a huge topic and this post is very long, but it still doesn’t cover all the nuances. This post is focused on the issue of consent and boundaries specifically, so please don’t be too disappointed if it doesn’t cover everything you thought it would. Suggestions for future posts are welcome as always.

Consent, Consent, Consent

The most important thing about reaching out to someone for support with a mental health issue is to explicitly ask for their consent to have this conversation. This means that, rather than sending them a sudden wall ‘o’ text on Facebook, you might first say, “Hey, can I vent to you about depression for a bit? You can respond whenever you have a moment.” Or in person, if the topic hasn’t come up organically in a way that suggests that they’re ready to hear about it, you might say, “Can we talk about some ED stuff I’m going through right now?”

If you want to talk to someone about things that are fairly likely to be triggering–examples include self-harm, suicidal ideation, eating disorders, homicidal ideation, and so on–it’s a good idea to include a content note. In a message or text, that can just look like “TW: anorexia”; in person, you might say, “Can I talk to you about some eating disorder issues I’m having. I might get into detail.” This is important because 1) the person you’re talking to might have their own issues, which you may not necessarily know about; 2) they may be in a space right now where seeing a sudden wall of text about a very serious topic might really stress them out; and 3) regardless, people can often help you better if they have some idea of what you’re going to talk to them about, especially when it’s something pretty serious like that. When I see “Hey, can I talk to you about anorexia?”, I put myself in a different headspace than when I just see “Hey, can I talk to you about some stuff?”.

When you message someone to talk to them about Heavy Stuff and do not give them a warning about the content or an opportunity to politely bow out, understand that you are making it very difficult for them to say no to you, especially if they’re not someone who feels comfortable asserting boundaries (and most people aren’t). You may not intend to make them feel this way, but that’s the effect it often has when you don’t check in to see if it’s okay first.

I’ve gotten sudden walls ‘o’ text while in class, while on dates, when I was just about to fall asleep in bed, while finishing an assignment on deadline, and all sorts of other inopportune times. It put me in a serious bind, because on the one hand I had a really serious message demanding my attention, and on the other hand, I had things that I needed to be doing. When someone suddenly sends me five paragraphs about having an eating disorder and being suicidal, it feels incredibly wrong to say, “I’m really sorry, but I’m busy right now and can’t talk.” I usually do it, but that’s only because I’ve developed very strong boundaries over the years. Most people haven’t.

Another way that you may unintentionally make it difficult for people to set boundaries is by getting their consent for a certain type of conversation (“Hey, got a minute to chat?”) and then, once they agree, making it clearly way more than a minute and more than just a “chat” (“So I’m really really depressed and I think I’m about to lose my job and I just don’t know what to do, I’m almost out of savings and–“). Phrases like “got a minute to chat” and “hey what’s up” are vague, sometimes intentionally so. Once someone gets into a conversation with you, it’s almost impossible to then be like, “Um, actually, I thought this would just be a casual chat; I’m not really available for a conversation like this right now.”

If someone tells you that no, they cannot talk/listen right now, respect that answer, even if it feels unfair or unreasonable. They may in fact be lazy. They may in fact be selfish and callous. They may in fact completely not understand what you’re going through and if they did then they’d listen. They may in fact just be shallow people who want everything to be sunshine and daisies all the time. They may be all of those things, but they still deserve to have their boundaries respected.

The Importance of Being Specific

Consent is one reason why, when you’re reaching out to someone for support, it can be helpful to be as specific and clear as possible about what you need from them. (I say “as possible” because that can be really difficult when you’re in a moment of crisis.) If they know what they’re being asked to do, then they can actually consent to it. But taking a moment to think about what you need from others right now will help you, too–it’s easier to get what you need if you know what that is and ask for it:

“Hey, I need to just vent at someone about some depression stuff. Would you be able to listen for a bit?”

“I’m feeling down and it would be helpful to distract myself. Could you come over and play video games with me?”

“I’m feeling unsafe tonight. Is it ok if I spend the night at your place and just do my own thing with someone else in the room?”

You may, like me, be concerned that if you let people know you’re having a hard time, they’ll try to offer you types of help that you don’t need. In that case, it can be a good idea to be clear about what you’re not looking for, too:

“I’m going through a really rough time. I don’t really want to talk about it, but could we just chat for a while about something else?”

“I’m having a really bad day. I’m not really up for talking to anyone, but could you send me some cute animal videos?”

What if you want support but have no idea what would help? In that case, being specific is clearly impossible. I think it’s better to be transparent and say something like, “I’m feeling really bad and to be honest I don’t know what would help right now. I just wanted to reach out to someone.” Hopefully, your support person might have some ideas about how to help or what to say.

The reason this sort of transparency is helpful is because otherwise, the person might assume that you do need something specific and you know what that is, but that they need to somehow intuit it. Or they may ask you what they should do, which can be stressful for you to have to respond to.

As a more long-term strategy, though, it might be helpful to try to figure out what other people can do that would help you feel better, so that you know what specifically to ask for from them. If you have a therapist, they can help with that project. If not, you can ask others who struggle with similar issues (maybe on a support forum if you don’t know anyone personally) what works for them. Just because you have similar issues doesn’t necessarily mean the same things will work for you, but there’s a good chance you’ll find something.

Why This Can Be So Hard

Back to the issue of boundaries. For many of us, the pain of mental illness is so strong that it’s hard to empathize with someone who says it’s too much for them to hear about. Resentment can build. You think: “They can walk away from this conversation, but I have to live with this my whole life.” When someone is unable to listen to us talk about how awful we’re feeling, that can kick up those feelings of resentment.

But just as we ask our friends, partners, and family members not to take it personally that we have a mental illness, we should try not to take it personally when they have their own feelings and limits. There’s a reason psychologists have a concept called “vicarious traumatization,” and a reason why therapists and social workers have such high burn-out rates. Of course, you may not be asking them to do anything close to what a therapist does, and they may not experience it as “traumatization,” but the point is that being very close to someone’s pain can have an impact. In addition, your support people may be dealing with their own mental health issues, which you may or may not know about. They may want to listen to you, but may be unable to because of what it brings up for them.

One last thing I want to say about this is that for me personally, depression made it really difficult to see how my own pain was hurting others. I don’t mean in that awful way that we talk about, where people take our pain as a personal insult or expect us to be happy all the time. I mean that seeing someone you love in pain hurts. Legitimately. But when I’m depressed, I think I’m so awful that I don’t understand how anyone could possibly care that I’m hurting–even though I reach out to them with the hope that they’ll listen. (Mental illness causes many such contradictions.) And when they say that they care so much that it’s really difficult for them to hear about it, it sounds like they’re insulting and patronizing me, presumably to “get out” of having to listen to me. That this perception is often wrong is something that I had to recover from the worst of it before I could understand.

Self-Forgiveness

Reading this, you may realize that you have overstepped boundaries in the past. (Or maybe you already knew this.) Mental illness can make people feel like they’re horrible and deserve to die, and realizing that you have overstepped boundaries may exacerbate this.

Try to be gentle with yourself. Mental illness can provoke boundary-crossing behavior, and while it’s important not to use this as an excuse not to work on it, it also means that you’re not a terrible person, and you can get better–both in terms of boundaries and in terms of your symptoms themselves.

Talking about this issues presents what The Unit of Caring refers to as a competing access needs problem. Some people will really benefit from this advice. Some people may already be so terrified of violating boundaries that they almost never ask for the help they need. (This may be surprising given that I wrote this post, but I’m squarely in the latter group.) Mental illness also complicates matters in that people may simultaneously be excessively terrified of crossing boundaries, while also sometimes crossing boundaries!

If you feel that implementing this advice will do harm to you, then don’t implement it. However, I would posit that it would actually be helpful for most people, because my core message here isn’t “You should be Very Very Careful about not violating anyone’s boundaries,” but rather “Hey, here’s how to reach out for help in a way that respects people’s boundaries.”

Supportive People Who Aren’t Really

One reason you may be terrified of crossing boundaries is because you may have done your due diligence and followed all this advice and then still had people tell you that you’ve overwhelmed and burdened them and they never wanted to help you this much but felt obligated to. There’s a lot going on here, such as:

A duty-centered view of relationships (believing that being your friend/partner/family member obligates them to help you whether or not they want to or can safely do so)

Simple ableism: believing, however implicitly, that your mental illness makes you so weak and helpless that they are ethically obligated to help you, no matter at what cost to them

The plentiful existence of people who act in these ways makes it difficult to talk about boundaries and mental illness. If we’re constantly accused of being burdensome and asking for too much no matter how careful we are, that can easily obscure the fact that sometimes we really do reach out to people in ways that make them feel like they can’t say no. But remember: both of these things can be true, and are true. They sound contradictory but are not.

There’s no simple way to fix this problem. If you’re not sure whether or not you’re being mindful of boundaries, it might be worthwhile to consult a friend that you trust to be honest and ask them for feedback. And if you notice that there are people in your life who keep telling you that it’s okay to vent about your feelings or to ask them to take you out for ice cream but then it turns out that they never wanted to help you and only did it out of a sense of obligation, it might be time to downgrade these people from “friend that I ask for mental health support” to “acquaintance that I talk about Marvel films with.”

Whatever their reasoning for not being honest (or not being aware enough of their own needs to be able to be honest), it’s not a healthy dynamic. It’s the sort of dynamic that leads many of us to feel like such awful burdens all the time. It’s the sort of dynamic that can make it really difficult to take this blog post seriously, because if people are constantly calling you a burden when you’re not, you may not be able to recognize the ways in which you might actually be crossing boundaries.

Of course, supportive people are difficult to come by and it can feel counterintuitive to stop going to these people for support when they seem to be acquiescing. (And if you ever feel like it’s a matter of life or death, please, do whatever you need to do to keep yourself safe.) But they’re not, in fact, supportive people. If they were, they would properly set boundaries with you in a way that’s compassionate but still assertive. Pretending to consent and then blaming you for believing them is an unkind and unsupportive thing to do.

~~~

If you are in crisis and do not feel safe, and none of your support people are available to talk to, please call 911, go to the ER, or call one of these hotlines if you don’t feel safe doing the first two things:

This Captain Awkward post about supporting friends with depression has been bouncing around in my head ever since I read it when it was first posted last August.

Since I’ve been having my own little depressive episode since December or whenever that was, I’ve been wanting to shout this entire post from the rooftops (except, of course, I don’t have the energy). I’ll highlight this part in particular:

I think one thing you can do to help your friends who are depressed is to reach out to them not in the spirit of helping, but in the spirit of liking them and wanting their company. “I’m here to help if you ever need me” is good to know, but hard to act on, especially when you’re in a dark place. Specific, ongoing, pleasure-based invitations are much easier to absorb. “I’m here. Let’s go to the movies. Or stay in and order takeout and watch some dumb TV.” “I’m having a party, it would be really great if you could come for a little while.” Ask them for help with things you know they are good at and like doing, so there is reciprocity and a way for them to contribute. “Will you come over Sunday and help me clear my closet of unfashionable and unflattering items? I trust your eye.” “Will you read this story I wrote and help me fix the dialogue?” “Want to make dinner together? You chop, I’ll assemble.” “I am going glasses shopping and I need another set of eyes.” Remind yourself why you like this person, and in the process, remind them that they are likable and worth your time and interest.

Talk to the parts of the person that aren’t being eaten by the depression. Make it as easy as possible to make and keep plans, if you have the emotional resources to be the initiator and to meet your friends a little more than halfway. If the person turns down a bunch of invitations in a row because (presumably) they don’t have the energy to be social, respect their autonomy by giving it a month or two and then try again. Keep the invitations simple; “Any chance we could have breakfast Saturday?” > “ARE YOU AVOIDING ME BECAUSE YOU’RE DEPRESSED OR BECAUSE YOU HATE ME I AM ONLY TRYING TO HELP YOU.” “I miss you and I want to see you” > “I’m worried about you.” A depressed person is going to have a shame spiral about how their shame is making them avoid you and how that’s giving them more shame, which is making them avoid you no matter what you do. No need for you to call attention to it. Just keep asking. “I want to see you” “Let’s do this thing.” “If you are feeling low, I understand, and I don’t want to impose on you, but I miss your face. Please come have coffee with me.” “Apology accepted. ApologIES accepted. So. Gelato and Outlander?”

I think it’s a natural impulse to assume that the only way you can help someone who’s in a lot of pain is to try to address it directly, that maybe if they Vent to you and Get It Off Their Chests then they’ll feel better, and maybe sometimes they do, but I never did. I’ve written before that a lot of unnecessary pain and drama happened in my life because people thought they were willing to hear me vent and I thought it would be a good idea to take them up on the offer.

I truly believe that all of these folks mean well, but I truly believe that they don’t really understand depression, because they treat it like it’s just a LOT of sadness. Like it’s just like getting fired from five jobs at once, or being dumped by five partners at once (hey, if you’re poly, it could happen), or having a Really Bad Day where literally every single thing that could go wrong goes wrong, from getting humiliated in front of the whole office by your evil boss to losing your keys to walking into the subway station just as the express train pulls away to realizing you’re out of toilet paper right when you need the toilet paper.

Those things are not like depression. Those things are just really shitty.

One thing about depression is that it makes it really difficult to access the parts of your life that are genuinely good. For some people, this takes the form of anhedonia–losing pleasure or interest in things you used to enjoy. Not necessarily completely or all of the things, but sometimes completely and all of the things. For some people, this can mean that watching their favorite show or playing their favorite game is suddenly not fun anymore. For some, it can mean that trying to socialize with their good friends feels like reading a really boring story and not being able to actually interact with the story in any way. For others, it can mean not perceiving food as tasty anymore.

Another way this plays out is that you may still enjoy things, and know that you enjoy them, but lack the motivation to make those things happen. This seems very common. It’s a big part of depression for me. I do still enjoy spending time with my friends, but it usually doesn’t occur to me to invite them to do anything or to chat with them online, and if it does occur to me, I immediately come up with a bunch of reasons why I can’t do it and then I forget about it and end up reading for hours instead. Sometimes writing is this way for me too. But if I can just find a way to do the thing, I almost always find that it was worthwhile and wish I’d done it sooner.

So Captain Awkward’s advice about connecting with friends with depression is very on-point. If you just plop the ball down in their court, they’re probably going to look at it in confusion for a little bit and then toss it off into the bushes (possibly with a lot of shame and guilt). If you walk over, offer them the ball, and let them know how they can throw it back if they choose to, they’re much more likely to throw it back.

So here are some well-intentioned but not very helpful ways that people try to do this, and some better ways.

Less helpful: “We should hang out sometime!”*

More helpful: “I’d love to hang out if you’re up for it. Want to do that on Thursday night?” [if no] “Ok! Should I ask again next time I’m free?”

Less helpful: “Let me know if you need help with anything.”

More helpful: “Is there any way I can help?”

Even more helpful: “If it would be helpful for you, I’d love to [cook you a meal once a week/help you find a therapist/watch TV with you when you need a distraction. What do you think?”

Less helpful: You can talk to me if you need to.

More helpful: What helps you feel better when you’re feeling depressed? Is that something I can help with, and that you’d want me to help with?

Sometimes a friend with depression will say no to a lot of things and decline all or most of your invitations. This can make you feel like you’re overstepping boundaries and should immediately leave them alone until they reach out to you themselves. Pay attention to this feeling: it’s true that when people keep saying no to things you ask, it’s probably a good idea to stop asking. However, depression can also cause people to say no while wishing they could say yes.

The way to deal with this is not to assume, but to just ask directly: “You’ve said no the past few times I’ve invited you to do something. That’s okay, but I just wanted to check: would you like me to keep inviting you?” I’ve done this before with other people dealing with depression and found that they often respond that they do want me to keep asking, and they hope that one of these days they’ll be able to say yes.

For many people, depression causes a pervasive sense of disconnection from the world and from other people. When I’m having a depressive episode, I feel like I’m not part of anything, like I’m just one person and I don’t matter, like I could disappear and nothing would even change, etc. I feel like there’s a glass wall between me and everyone else. I feel like I can’t do “normal” things like laugh at a sitcom or make someone happy or fall in love. I feel like an alien sent here to try to learn how to act like a human being only I’m completely failing.

So for me, the most helpful thing that someone can do is to help bring me back into connection with others. This is why I find venting mostly useless. When I’m venting, I’m still only talking about my depression, and while the person I’m venting to may be very kind and a very good listener, this isn’t something we can connect over, you know? It’s not the same as a two-sided conversation about difficulties we’ve dealt with in our lives. It’s totally one-sided. It’s just me, talking about the exact thing I need to learn how to stop ruminating over.

Helping a depressed person feel more connected to others is a tall order even for the most empathic friend, but there are some things friends can do that might be helpful, some of which Captain Awkward mentioned.

One is to ask for their help with something they’re good at. Make it clear that you really value this person’s skill or experience with this thing. This helps them feel that they have something to offer others, which is a feeling that’s pretty thin on the ground when all you can think about is how sad you are.

Another is to talk to them about some of your own struggles. I’ve always found that hearing about other people’s problems gets me out of my head a little by activating my empathic or problem-solving sides (depending on whether they’re just sharing, or asking for advice). It’s also a reminder that everyone struggles, even if the magnitude of that struggle varies for different people at different points in time. This may be somewhat specific to me, but seriously, the kindest thing someone can do for me when I’m depressed is to talk about their problems–it means I don’t have to talk about myself (hard to do when all I can say is “yup, still sad”) and I also don’t have to pretend to be happy while they share happy things (as much as I wish I could just be happy for others when I’m depressed, that is basically impossible).

Another is to plan fun things with your circle of friends, if you share one, and include them in that. While not everyone is up for group things, especially when they’re depressed, I personally find it more helpful than hanging out with someone one-on-one. When I’m with a group of friends, there’s inside jokes and lively discussion (that I don’t have to personally initiate!) and it makes me feel like part of something again. Seriously, last month I spent a week in Minneapolis (where I have a shocking number of close friends) and my depression was basically on hiatus that whole week, because I was just always surrounded by great people that I trust and care for, and they were being interesting and/or funny all the time, and it was great.

Remember that no matter how patient you are, and how much your friend may want to be able to spend time with you, sometimes it’s just going to be impossible. Some people disappear for weeks or months at a time when struggling with depression. It’s legitimate to feel sad that you’re not getting to see your friend, but please don’t take it out on them or make them feel guilty. Believe me, they already feel like human garbage, because that’s how depression tends to make people feel. Remember the ring theory and find someone else to talk to about your legitimate feelings about not getting to see your friend who has depression. If not being able to see them for a long time causes you to no longer feel close enough to them to consider them a friend, that’s also legitimate. Accept that nobody’s at fault and move on. They didn’t get depression as a personal slight against you.

The most important thing about supporting someone with depression is to be really self-aware. Make sure that you’re really doing it because you care about them and want them to feel better, not because you need the validation of Fixing Someone’s Problems. Depression isn’t going to be fixed by someone’s friends, no matter how kind and patient they are. You may invite them to a thing and they may appear and seem totally happy and then later that night they post another Facebook status about how awful they feel, and you may feel like you Failed and you might as well not have bothered, but trust me–it’s more than just in-the-moment feelings. I may feel like shit, but I’ll remember somewhere in the back of my mind that I have friends who love me and who make an effort to get me out of my room, and that matters.

Besides that, stuff like friendship bonds can be a protective factor against future depressive episodes. Your friend will eventually recover from their current episode, and now that they feel better, they may be able to fully internalize how much people care about them and how connected they are to others. That can help prevent a future relapse. That matters.

So don’t do it because you’re hoping to see obvious and immediate results. Don’t make a person with depression carry that burden for you.

~~~

Now that I’ve reached the end of what I have to say, I just want to note that it’s almost impossible to even write about this (especially given that I am currently depressed) because the response is always immediately “Yeah well you don’t speak for all depressed people, my partner/best friend/I are totally different!”

Yes, I don’t speak for all depressed people, but I speak for more depressed people than just myself. If you already know for a fact that this doesn’t apply to the person you’re thinking of, just ignore it. (Or write your own article that describes your own experience.) But you probably don’t know that, and you can open up a conversation about it by showing them this article and asking if they feel that it applies to them.

~~~

*I just want to state for the record that, depression or no, I have no idea what to do with “We should hang out sometime!” Are you merely expressing a preference for the sake of expressing it? Are you asking me if I also want to hang out? Are you asking me to plan/initiate the actual hanging out? In practice, I just respond, “Yeah, totally!” and then nothing ever happens.

A lot of what happens in therapy should only happen in therapy. (I’m looking at you, folks who oppose trigger warnings because “exposure is very important for overcoming trauma.”) But a lot of other things that happen in therapy are very applicable to the rest of our relationships and interactions. One of those is the tension between normalizing someone’s experience and validating it.

Normalizing someone’s experience essentially means helping them feel that their experience is normal. Short of memorizing statistics, the easiest way to do that is to relate what they’re telling you to something that’s happened in your own life. This is a very common conversational move. Someone tells you about a bad breakup and you say, “Oh, I totally went through something similar recently. It can be really hard.” Someone tells you their NYC subway horror story and you respond with one of your own. (We all have an arsenal of those.)

Validating someone’s experience is a more complex conversational move. To validate means “to demonstrate or support the truth or value of.” In the context of therapy or supportive conversations between friends, validating someone’s experience means letting them know not only that you believe them when they say that it happened–which can be particularly important when someone discloses, say, sexual violence or mental illness–but also that you affirm this as an “okay” thing to talk about or think about. The opposite of validating is to say “That’s not that big of a deal.”

Obviously, you can both validate and normalize someone’s experience in the same conversation. Therapists frequently do both.

However, the way of normalizing that we most frequently use in casual settings–relating someone’s experience to our own lives and selves–can get in the way of that.

For instance, someone says, “I’m having such an awful time getting out of the house this winter.” If you immediately jump in to say, “Oh, me too, it’s so awful, I couldn’t even make myself go to my friend’s birthday party because it was so cold out,” you may succeed in helping them feel like it’s okay to be having this difficulty, but you may also miss an opportunity to affirm the fact that their own unique experience is legitimate and difficult for them.

I get this often with fatigue. I try not to talk about being tired very much because I don’t like “complaining,” but sometimes I do mention it, and people usually jump in immediately to talk about how tired they are and how they only slept four hours last night and so on. But the thing is…my tiredness is a little different. I sleep at least 8 hours almost every single night, and have been for years. If I let myself, I would sleep 10 or 11 or more hours. I don’t know what it means not to want to sleep. Every day I daydream about coming home and going to sleep.

Of course my friend’s experience is also legitimate, and it sucks to only get four hours of sleep and feel shitty. But for them, not feeling tired as often as simple as finding the time to sleep enough. For me, absolutely nothing I have been able to try without medical intervention has helped.

So when I mention being tired and people immediately jump in to relate, I feel like I can’t talk about how extensively awful it is for me, because everyone feels tired! Feeling tired is normal! That’s just how life is! (Deal with it!)

On the other hand, some things feel bad not just in and of themselves, but also because of the shame and isolation that surrounds them. Mental illnesses are often like this because few people know a lot of people who are open about it (though that may now be changing). When I was first diagnosed with depression, I didn’t know even one other person who was (openly) diagnosed with it. I thought everyone else had it together and I alone was a failure. I saw the statistics on how common depression is, but they did nothing for me. What helped was to start meeting other people who struggled with it. Depression still sucked, and still does, but I no longer had to carry the burden of Being The Only Person In The World Who Can’t Even Be Happy.

How can you tell what someone needs in a given moment? How do you know if it’ll be more helpful to normalize their experiences, or to validate them?

Often there isn’t really a way to tell. In sessions with clients, I rely a lot on intuition and previous experience. But there are some things that people say that can serve as hints as to what they might need from you.

For instance, when people say things like, “I can’t believe I’m having trouble with something so simple,” or “I’m such a failure; I can’t even find a job,” or “Nobody else has all these problems,” that can be a sign that normalizing might be helpful. It can reassure them to know that other people do have trouble with these supposedly simple things, or that other people do actually struggle a lot with finding a job, or that other people do have these same problems. Sometimes what the person is dealing with really is shitty, but it feels a lot shittier than it has to because they think they’re the only one who’s so pathetic and incompetent as to have that problem.

On the other hand, when people say things like, “I know it shouldn’t even be a big deal, but–” or “Everybody probably deals with this but–“, pay attention to those but‘s. The part after the but is the part they have trouble accepting as valid. Everybody deals with it! It’s not a big deal! Therefore, what right do I have to even complain about it?

When someone says things like this, sharing your own experience and relating to them might not be as helpful. What they really need to hear at that moment is that their unique version of that probably-common problem is worthy of paying attention to and talking about. They might know perfectly well that other people have similar problems, but it still feels bad and that’s the part they want to hear acknowledged. Yes, everybody hates winter, but here’s how it sucks for me. Yes, everyone is tired, but I almost passed out after climbing a few stairs. Yes, I know you probably miss your family too, but I just really really miss mine today.

“Common” problems are easy to relate to. Most of us have had bad breakups or manipulative family members or really exhausting days. But rushing to relate your own experience closes off the possibility of learning more about their life. When you feel an urge to share your own experience, instead, try asking more about theirs and seeing if your experience is still as relevant as you thought.

With certain types of issues, relating your own experiences can also easily come across as one-upping even when you don’t mean it to–although, to be real, sometimes that’s exactly how people mean it. Please don’t one-up people. There’s no need. There is not a limited quantity of sympathy in the world, so there is no need to compete for it.

You might also accidentally relate to only a very small part of what they actually said, leaving them feeling misunderstood or unheard. For instance, if I share a story about a classmate saying something very hurtful and ignorant about queer people, and you share a story about a classmate saying something very inaccurate about cell biology, you may have missed the fact that the relevant part of my story wasn’t “a classmate said something silly” but rather “a classmate made a homophobic comment in class that impacted me personally.”

The urge to relate to someone’s experiences comes from a lot of places, I think. It’s a common way of trying to show someone that you understand. Showing someone that you understand them is a common way of earning their trust, respect, and affection. It indicates that you have things in common.

In therapy, of course, things are different in that the focus should always be on the client and their needs. But therapists do sometimes share stories from their own lives, and the purpose is slightly similar to how it works in casual conversations between friends–it’s a way for therapists to signal understanding of their clients, and also to let them know that they are not alone in some of their experiences. Sharing a personal story can be more powerful than simply saying something like “You’re not alone in that,” because it gives something more than a reassurance: it gives evidence. (Anecdotal, but still.)

Yet both in therapy and in life, sharing one’s own experiences can get in the way of fostering a better, deeper understanding of another person. It can also make it difficult for them to tell you more about their experience, because you’ve now turned the conversation back to yourself. It can seem very disingenuous if it’s clear to the person that you don’t actually understand very well at all.

And while we often tell ourselves that we relate to others in order to make them feel better, there sometimes is some selfishness in it. We want to prove to others that we “get it” so that we feel better about ourselves and our ability to understand and connect with people. A natural impulse, but that doesn’t make it necessarily helpful or productive all of the time.

I see this often in conversations about injustice. A marginalized person shares an experience they have had with discrimination or prejudice, and a person who is categorically unable to have the same experience nevertheless tries to relate something from their own life. Sometimes they relate an experience of being treated badly in a way that has nothing to do with their societal position, and sometimes they relate an experience that has to do with another dimension of identity.

There are definitely some important similarities in the ways in which many different marginalized groups are treated, but that doesn’t necessarily always mean that we can relate. The presumption of understanding can easily get in the way of actual understanding when a white woman assumes that her gender helps her understand someone’s experience of racism, or when a gay man assumes that his sexual identity helps him understand a trans woman’s marginalization. I mean, maybe it does, in a few limited ways. But we should always strive to learn more before assuming we “get it.”

I think a lot of people experience the urge to relate. I’ve definitely felt it. For instance, once a friend of mine who is Black was sharing some experiences of racism they had had, and I suddenly noticed a little gear turning in my brain trying to generate similar experiences from my own life that I could share. I thought, wait a minute, I never told my brain to do that! That wouldn’t be helpful right now. How could I listen fully if part of my brain was so busy trying to connect my friend’s experience to my own? How could I even come close to understanding their experience if I was already biasing that understanding by thinking of my own interpretations of my own experiences, which had nothing to do with racism?

This, I think, is what drives a lot of the confusion and miscommunication that happens around issues like race and gender. For instance, suppose a Black woman is telling me about how her coworkers and supervisors always assume she is angry and hostile when she isn’t. I start thinking about times when I have been assumed to be angry and hostile, and how that hurt, and how I dealt with them. Maybe I dealt with them by adopting a more friendly and cheery approach, and that helped. Awesome! I’m going to tell my friend about My Experiences and What Worked For Me!

Except that What Worked For Me is very unlikely to work for someone who is not white. As a white woman, I am not automatically assumed to be angry and hostile no matter what I do, generally speaking. So adjusting my demeanor, even though I felt that I was behaving appropriately before, might help change others’ perceptions of me in a substantially helpful way. A Black woman can be as painfully polite and deferential as she possibly can and yet she’s still likely to face that sort of stereotyping. Maybe if I’d listened rather than spent all that brainpower thinking about my own life experiences, I would’ve understood that.

(See also: Lean In by Sheryl Sandberg.)

Likewise, when I talk about feeling threatened by a man in public and men jump in to tell me that I should’ve Just Punched Him or Just Told Him To Fuck Off, they are thinking of their own experiences and how they might’ve reacted in that situation (for better or worse). A man who decides to Just Punch a man who is being offensive to him may end up getting hurt in a fistfight, but the consequences would be much more severe for me if I tried the same thing.

(See also: “Just call the police!”)

So, what do you do when someone shares an unpleasant experience and you have no idea whether or not relating something from your own life might be useful?

Here are some scripts:

“Do you think it might help to hear about something similar I’ve dealt with?”

“I’ve gone through something that sounds a lot like that. Feel free to ask me more about it if you want, or to just talk about your own stuff.”

“I know this may not necessarily fix the problem, but something that helped me with that was _____.”

“That sounds really hard, but you’re not alone in dealing with that.”

Alternatively, it’s almost always a good idea to ask them more questions (with the caveat that they don’t have to talk about it more if they don’t want to) so that you can understand what they’re going through better.

In social work school, we learn a lot about the importance of being very aware of what’s going on in our own heads as we’re trying to help others. That’s useful for any sort of interpersonal situation. It’s a good idea to go into these types of serious conversations with an awareness of what you’re bringing to the table, including your own needs and desires and biases. Many of us want to feel competent when it comes to understanding and helping our friends. That’s commendable, but it too easily turns into a search for affirmation from people who are busy trying to share their own troubles.

Don’t let your need to demonstrate your understanding get in the way of actually understanding.

I’ve been thinking more about Scott Aaronson. Specifically, I’ve been thinking about what he struggled with during adolescence, and about the (in my opinion, misguided) notion that feminism could have possibly been of any help to him.

The battle cry I’ve heard from men since Aaronson’s now-infamous Comment 171 was published is that feminist writers and activists need to be more mindful of situations like Aaronson’s when we choose our language and strategies. There seems to be a collective yearning for acknowledgement that the usual feminist rhetoric is not only unhelpful for people in the teenage Aaronson’s frame of mind, but actively harmful to them. There is one piece of this that I fully agree with, that I will get to later. But for the most part, I continue to feel a sort of frustration and exhaustion, and I think I’ve finally figured out why.

I wrote in my previous post on the subject that I feel that we (women) are being given all these male traumas and struggles and feelings to soothe and fix, as we always are. But now I understand why exactly I feel like we’re such an inadequate receptacle for these things.

I spent my formative years—basically, from the age of 12 until my mid-20s—feeling not “entitled,” not “privileged,” but terrified. I was terrified that one of my female classmates would somehow find out that I sexually desired her, and that the instant she did, I would be scorned, laughed at, called a creep and a weirdo, maybe even expelled from school or sent to prison. And furthermore, that the people who did these things to me would somehow be morally right to do them—even if I couldn’t understand how.

You can call that my personal psychological problem if you want, but it was strongly reinforced by everything I picked up from my environment: to take one example, the sexual-assault prevention workshops we had to attend regularly as undergrads, with their endless lists of all the forms of human interaction that “might be” sexual harassment or assault, and their refusal, ever, to specify anything that definitely wouldn’t be sexual harassment or assault. I left each of those workshops with enough fresh paranoia and self-hatred to last me through another year.

[…] Of course, I was smart enough to realize that maybe this was silly, maybe I was overanalyzing things. So I scoured the feminist literature for any statement to the effect that my fearswere as silly as I hoped they were. But I didn’t find any. On the contrary: I found reams of text about how even the most ordinary male/female interactions are filled with “microaggressions,” and how even the most “enlightened” males—especially the most “enlightened” males, in fact—are filled with hidden entitlement and privilege and a propensity to sexual violence that could burst forth at any moment.

Because of my fears—my fears of being “outed” as a nerdy heterosexual male, and therefore as a potential creep or sex criminal—I had constant suicidal thoughts. As Bertrand Russell wrote of his own adolescence: “I was put off from suicide only by the desire to learn more mathematics.”

At one point, I actually begged a psychiatrist to prescribe drugs that would chemically castrate me (I had researched which ones), because a life of mathematical asceticism was the only future that I could imagine for myself. The psychiatrist refused to prescribe them, but he also couldn’t suggest any alternative: my case genuinely stumped him. As well it might—for in some sense, there was nothing “wrong” with me.

[…]And no, I’m not even suggesting to equate the ~15 years of crippling, life-destroying anxiety I went through with the trauma of a sexual assault victim. The two are incomparable; they’re horrible in different ways. But let me draw your attention to one difference: the number of academics who study problems like the one I had is approximately zero. There are no task forces devoted to it, no campus rallies in support of the sufferers, no therapists or activists to tell you that you’re not alone or it isn’t your fault. There are only therapists and activists to deliver the opposite message: that you are alone and it is your privileged, entitled, male fault.

It’s worth reading the entire thing, and reading it carefully. (Aaronson’s defenders are correct that some people have been making accusations of Aaronson that are directly refuted by things that he said in the very same comment. Let’s not do that.)

Here’s what I thought. If someone came to me and said that he earnestly believes that he will be “expelled from school or sent to prison” if a woman finds out that he finds her attractive, and that he has “constant suicidal thoughts,” and that his daily existence is characterized by “crippling, life-destroying anxiety,” I would not recommend that he read Andrea Dworkin or attend a sexual assault prevention workshop. I would recommend, gently and tactfully, that he go see a therapist.

I would do that because these are very serious issues. They are serious enough that, when a client tells me that they have “constant suicidal thoughts,” there is an entire protocol I’m required to follow in order to ensure that they are safe and receive appropriate care if they accept it.

I will not speculate about what mental illness Aaronson could have theoretically been diagnosed with in his adolescence; I oppose such speculation and it’s actually irrelevant. I don’t need to diagnose him to say that he had serious issues and could have really benefited from treatment. (However, I may reference some diagnoses in what follows, not to suggest that Aaronson had them but to show how mental illness can interact with other life circumstances.)

Maybe Aaronson didn’t think to seek therapy as an adolescent, because therapy and mental illness are still quite stigmatized and would have been even more so when he was younger. Maybe nobody close to him noticed or cared what was going on, and therefore did not encourage him to seek therapy. Maybe the psychiatrist he asked to prescribe castration drugs did not pause to consider that a teenager seeking castration is a red flag, and that maybe he should refer him to a colleague who practices therapy. Maybe, maybe, maybe.

But why aren’t we talking about it now? Why are people blaming feminism–the feminism of the 1970s or 80s, no less–for failing to cure what appeared to be a serious psychological issue? Why are people claiming that the solution now is simply for feminist writers and activists to be more compassionate and considerate towards male nerds like Aaronson, as though any compassion or consideration could have magically fixed such a deeply layered set of deeply irrational beliefs?

This troubles me. If I ever start claiming that, for instance, I’m a terrible person and deserve to literally die because I’m queer, or that I cannot be in the same room with a man without literally having a panic attack, I sincerely hope that people advise me to seek mental healthcare, not to read feminist literature.

Lots of helpful things can harm a small subset of people because of that subset’s individual traits. For instance, there are a lot of PSAs about washing your hands to prevent the spread of disease and things like that. But some people have OCD and wash their hands compulsively, to the point that they’re hurting themselves physically and having trouble accomplishing daily life tasks because they have to wash their hands so much. I can imagine these PSAs being extraordinarily unhelpful to them.

We also often hear about the importance of donating to charity. Most people could probably donate more to charity if they wanted to. However, some people compulsively donate so much to charity that they harm themselves or their families. I can imagine this being exacerbated by someone telling them how important it is to donate to charity. Perhaps they feel they are never good enough.

I can see how feminist literature might have functioned in a similar way for Aaronson. The truth is that most men are about as far away from his mindset as you can get. Some are even the opposite extreme. Most men spend very little time thinking about how their behavior impacts women. Most men need to spend more time thinking about it. But how could he have known that these feminist books were not for him? If they were to put on the cover, “If you’re a great guy who does not hurt women, you don’t need to read this,” well, no man would ever read it. They all think they’re great guys who do not hurt women, even though some of them rape women.

Neurodiversity is an axis of privilege/oppression. People who suffer from mental illness or whose brains are set up differently from what is considered the “norm” (such as people with autism) lack privilege along this axis. They have difficulties because our society is not made to accommodate them. However, if these people are white, or male, or straight, or cisgender, or so on, they still benefit from the privileges afforded to people in those categories.

For instance, despite all his other fears and anxieties, Aaronson did not have to live in constant fear of being sexually assaulted, because he is male. He did not have to live with a significant risk of being harassed or brutalized by the police, because he is white. He did not have to deal with having people constantly refuse to identify him as the gender he identifies as, because he is cisgender. He did not have to struggle to physically access places he needs or wants to go, because he is able-bodied. Of course, he still faces some risk (in some cases fairly negligible) of all of these things, because having privilege doesn’t shield you from everything.

However, as a person who was (apparently) neuroatypical, Aaronson did have to live with “crippling, life-destroying anxiety.” He did not appear to have access (even if it’s just because he didn’t know to ask for it) to mental healthcare that could have helped him. He was forced to spend years feeling horrible. If he told people how they felt, they may have blamed him for it, because victim-blaming is a key component of our society’s oppression of neuroatypical people. Had he lacked some of the other privileges that he had, such as race and class, he may not have been able to access the apparently-useless psychiatrist that he did access.

Aaronson claims that he did not have “male privilege” because he did not feel that he had it. I’ve addressed arguments like these before. He presumably did not feel privileged because on one very salient and relevant axis, he certainly was not.

But otherwise, having or not having privilege isn’t actually dependent at all on how you feel. You have it or not. Men on the street hurl sexual obscenities at you or they do not. Cops stop you and slam you to the ground for no reason or they do not. You are allowed to marry someone of the gender(s) you’re attracted to or you are not.

Aaronson might be interested (or not) to know that many feminists are busy fighting to ensure access to mental healthcare for everyone, and an end to the stigma that prevents people from seeking help. But maybe that’s irrelevant now.

As I mentioned earlier, I am taking one piece of Aaronson’s (and the many others who have echoed him) criticism to heart. Namely, feminist materials need to be better at specifying what to do rather than just what not to do. Now is a good time for a reminder that I offer a workshop on this exactly, with a light-hearted tone and lots of audience participation and definitely no yelling at men that they are horrible awful creeps no matter what they do. I am far from the only person who offers such materials, but it would be cool if there were more. That said, anyone claiming that feminism does not offer this at all has quite clearly not done their research. Andrea Dworkin and some random shitty college sexual harassment training are not the only resources feminism has to offer.

But even then, your average casual feminist blogger or columnist cannot take responsibility for fixing the problems of someone who apparently sincerely believes that speaking to a woman will get him sent to prison. Or someone who is literally unable to talk to a woman because they have so much social anxiety. These are issues for professionals to deal with. Professionals can affirm. They are there to hold your feelings and make you feel comfortable and supported. They can teach social skills. They can help you examine maladaptive and irrational thoughts. They can help you learn how to cope with anxiety. That is what therapists are for. They are imperfect, but they are trained for this. I worry about placing this responsibility on every feminist with a blog.

Aaronson claims in his comment that “there are only therapists and activists to deliver the opposite message: that you are alone and it is your privileged, entitled, male fault.” I’m not sure if this comes from experience or is purely the creation of his mind with the biases that it had at the time. If Aaronson went to see a therapist and that therapist shamed him, then that therapist is wrong and does not deserve the title. (I’m not trying to do a No True Therapist fallacy here; I’m just pointing out that shaming people is against our ethics and if you cannot not shame people then you should not be a therapist.)

If Aaronson did not see a therapist, perhaps because he was afraid that they would shame him, then that’s unfortunate. And I don’t blame him. But I still think that we should be encouraging people with such pronounced irrational beliefs to seek therapy, not feminist literature.

No wonder I was so frustrated when I wrote that earlier post. I felt like feminist writers are being asked to do the job of a mental healthcare professional.

~~~

A few relevant points that I did not have time to expand on here, but may in the future:

Part of the reason that a lot of what Aaronson read/watched was so shaming towards men was probably because it was shaming towards sex and sexuality in general. Especially those college sexual harassment trainings, some of which are woefully retrograde. It’s important to remember that stigma/shaming around sex is something that is so entrenched in our culture that it’s bound to show up all over the place, even, yes, in feminist literature.

Aaronson claims that all the feminist literature he read confirmed his belief that straight men are awful and violent. While this may be so–I haven’t read Dworkin and don’t intend to–I have also personally watched men respond to materials that were not at all whatsoever shaming of men by claiming that they were being shamed by those materials. This seems to be a very common bias. They expect to be shamed by feminist materials, so they feel shamed by them.

I have seen dreadfully few discussions about how everyone–especially non-/anti-feminist men and women–perpetuate toxic ideals about masculinity. It’s usually not feminist teenage girls slamming shy nerdy boys into lockers and publicly humiliating them, is it? We should talk more about that. Unfortunately, most men dislike talking about toxic masculinity, because they think that “masculinity” is synonymous with “men,” and perhaps also because they have bought extensively into this ideal and appreciate the privileges it affords them.

There needs to be a space where we can say, “Wow, that is really awful, I’m sorry you felt that way and had to live with that, but I need to point out that your interpretation of things was inaccurate.” Because right now, it’s looking to me like anyone who includes the latter part of that sentence is accused of hating men or lacking compassion. If I read a Richard Dawkins book, came away with the idea that Dawkins believes that all religious people should be put to death, and therefore started to fear for the lives of my religious relatives, I would want someone to try to explain to me that I had misinterpreted the book. It would not be compassionate at all to allow me to continue believing that Dawkins was calling for my relatives’ deaths. It is not compassionate to allow Aaronson to believe that feminists want him to never, ever so much as kiss a girl. (A moot point now, but it wouldn’t have been earlier.)

It is also entirely possible that all the feminist literature that Aaronson read was woefully inadequate. (I disagree, and wish he had picked up bell hooks, but let’s grant it.) Feminism is, like every other field of study, constantly advancing and finding new ways to analyze and advocate. The feminist literature of the past decade or so focuses a lot more on helping men than the feminist literature of the 1970s and 80s. But feminist activism still consists mostly of women, and when men join in, they often try to speak to us about our own issues than to other men about men’s issues. And women, naturally, will focus first on issues we primarily face, some of which are life-threatening. Men, please, don’t stand around and lament the fact that feminists are not addressing your problems. Familiarize yourself with feminist principles and join in.

The truth about mental illnesses that many of us have learned is that they change you for good. Even after the symptoms are gone, the medication gradually reduced to nothing or stabilized at a dose that works, something remains. (And for many of us the symptoms are never entirely gone.)

Depression left my scaffolds–indeed, my very foundation–cracked. I’m okay, even joyful, much of the time. But it feels a little flimsy.

One of the ways this plays out in my daily life is that I have problems with intimacy. I don’t mean the sexual euphemism, but rather the ability to be vulnerable, to let people in, to be seen as you are, to be comfortable with closeness.

I am intensely uncomfortable with all of this.

I hate talking about myself, whether it’s positive or negative. I hate feeling like I need someone’s help to deal with emotions. I hate wanting someone’s help to deal with emotions even when I know I don’t need it. I hate the first time I tell someone I love them and I hate many of the subsequent times too. I hate it when people know that I miss them. I hate being visibly upset around someone, which means that if it’s at all possible to leave, I leave. I hate expressing any emotion besides joy and anger (which I rarely feel) to anyone. I hate it when someone says things to me in an attempt to build intimacy but I don’t know what to do so I say nothing. I hate when people notice emotions I didn’t intend to share. I hate when they tell me this as though it’s going to somehow endear them to me. I hate that there’s nowhere I can cry without being seen or heard by someone.

So relationships, whether platonic or romantic or sexual or some combination, are difficult.

Some people have difficulties like these for their whole lives, but for me, it happened as a result of depression. And, ironically, depression is also the thing that’s hardest for me to share with people.

During my nine years of depression–in fact, probably my whole life up to and including that–I was very different. My experience of mental illness was that it triggered a sort of leaking of thoughts and emotions. I literally lacked the ability to hold them in. They spilled out of my hands, like when I try to move a big pile of laundry from the washing machine to the dryer and little bits and pieces–a sock here, a tank top there–keep falling on the floor. I remember crying apropos of nothing on the band bus in 10th grade and telling my boyfriend that there’s no way to be happy when you hate yourself. Fifteen is old enough to know that this is not an appropriate thing to say. It didn’t matter. It just came out.

It’s not like I didn’t try to plug the leaks. In 6th or 7th grade, I decided to keep a record in my journal of “things left unsaid.” Each day I intentionally tried to shut myself up at some crucial juncture, and rewarded myself for it by writing it down in the notebook later–the thing left unsaid, the person I didn’t say it to, and the reason I didn’t say it.

Years later, what I learned about psychology and behavior change suggested that this could be quite an effective strategy for some people. But it didn’t help me much, because my problem wasn’t purely behavioral. When I looked at those entries later, I noticed how many of them had to do with hurt feelings. “Thing left unsaid: that I was upset about what _____ said about my outfit. Reason: because it wouldn’t make a difference.”

I tried so very hard, but everything hurt. If they couldn’t read it explicitly in my words, they read it implicitly in my face, my body, my tone. I couldn’t hide it. I gave up writing the entries within weeks because it was already too late, everything was leaking out and I couldn’t patch the holes fast enough. In college the dam broke completely, and everything from those little hurts all the way up to wanting to kill myself became common knowledge for those who interacted with me a lot.

For a while it was okay. I thought that being so open was keeping me going–and, as I’ll get to in a moment, it was important in some ways–but what it ultimately did was it completely broke me. It destroyed any sense of self-respect, independence, and competence that I had. When I confided my depressive feelings to someone, usually a partner, I felt like garbage. I felt so much more shame about the act of confiding than I ever did about the feelings I confided themselves.

If you’ve ever had to call the last person you want to speak to right now because they’re the only one available to talk you out of slashing your own wrists, then maybe you know what I’m talking about.

You have to reveal. You have to open up, in order to live. You have to tell it to the therapist and the psychiatrist and your parents and your partner and anyone else who is in any way responsible for your well-being.

You tell people the darkest most horrible things not because you trust them and want to let them see this part of you, but because you have no fucking choice.

And so the concept of “opening up” has been totally ruined for me, because I didn’t get to save it for those special, bonding late-night conversations with someone I feel ready to show myself to.

I had to do it.

Now I don’t.

And not having to feels like freedom. It feels like victory. It feels like independence, finally. It feels like adulthood, although it shouldn’t. It feels like maturity, although it shouldn’t. It feels like wholeness. It feels like safety.

It feels like recovery.

So now I sit at the computer with words typed into the chat box–“I feel sad,” “I can’t stop crying,” “I miss you so much”–and I can’t send them. I want to send them and I don’t want to send them. Not wanting to send them almost always wins out.

In a way, intimacy was easy when I was depressed. I wore it on the outside and it created a sense of intimacy with many people almost instantly. New partners saw my neat little red scars so early on, too early on. “We’ll work on that,” said one, an aspiring psychologist. “I wish you wouldn’t do that,” said another.

Now nobody has to see, and it’s almost impossible to want it any other way. Intimacy has gotten much harder. Perhaps mirroring my own style, new partners disclose little and so I lose interest in them quickly, convinced we have nothing in common besides politics.

Instead I write. The stress of work, the rush of falling in love, the little depressions that come and go, the grief of losing my old lives, the fear of the future–they sink into paper and that’s where they stay.

It’s lonely and isolating as hell, but it beats feeling opened up and exposed.

And now, although I’m known as someone who talks about depression a lot, I don’t really talk about it. I speak obliquely of it, the way someone might mention the passing of a loved one without ever speaking openly of their grief.

I can say that there is fatigue. I can say that it feels sad and numb and dark and hopeless. I can say that I wanted to die. I can say that my head was–still is, much to my constant disappointment–fuzzy and slow, memory useless, words perpetually at the tip of my tongue but left unspoken. I can write this blog post about how depression has affected my ability to desire, build, and feel intimacy.

But I do not ever, not anymore, tell you how it really feels. I will not make you listen to me tell you I hate myself I hate myself like I’ve never hated anything before and I wish I could rip my body and my mind to shreds–

No, I stay on a meta level. I’m comfortable talking about it conceptually.

But the feeling of depression itself? That is a dark room into which I want to go alone. I don’t want anyone knocking on the door trying to get me to let them in. I don’t want to have to hold their hand and guide them around the sharp corners they can’t see, because when I’m in that room, I need to be caring for myself. Not for anyone else.

Of course, it always starts out with them hoping to care for me, but that’s never how it ends up. People end up needing my support to navigate the nightmares in my own head.

Well, I’m sorry, but I just don’t have the mental fortitude for that. Caring for one person–me–is enough.

Presumably, I don’t have to be stuck this way for my whole life just because I have/had depression. I’m hoping to start therapy again soon, for this and for other reasons. But for now, as I reflect on myself and my life at this very special (for me) time of year, it’s hard not to feel hopeless about all the little things I can no longer do, at least not without lots of anxiety and fear. Like tell someone how the stress actually feels. Or talk to someone about how powerless I feel in my work. Or ask someone if they can talk to me for a while to help me get my mind off of things.

In this way, and in many other ways, mental illnesses may never end, or may take much longer to end than we expect, and there is no hopeful cheery note for me to end this on.

Therapists, like many professionals who work directly with clients, need to present themselves confidently in order to be effective, even when they’re not feeling very confident. It can be difficult for therapists to admit that they have or could be wrong, or that they don’t know everything. Like doctors and teachers and others, therapists worry that acknowledging their own limitations will erode their credibility and trustworthiness. When your livelihood depends on people finding you credible and trustworthy, that adds to the aversion of being wrong and admitting mistakes that virtually all of us already experience.

Yet we have to learn how to admit and accept that we are sometimes wrong–not only because it’s a foundation of accountability and ethical practice, but also because clients can often see through that facade, and they won’t like what they see. It’s difficult to trust someone who will never–can never–admit that they’re wrong.

This was going through my mind as I read one of my required texts for school, Psychiatric Interviewing: The Art of Understanding. “Psychiatric interviewing” is really just a term for the process of therapists asking their clients questions, so the book covers a lot of very important ground. While I’ve found it useful so far, a few things irk me about it.

For instance, the author has a strange preoccupation with labeling clients using the article “the” in a way that implies uniformity. The text is laden with references to what “the paranoid patient” may do or how “the guarded patient” may behave in an interview. This type of language is not only dangerously vague (who qualifies as “the paranoid patient” as opposed to “a person who has some paranoid thoughts”? Who gets to make that determination, and using which measure(s)?), but stigmatizing to therapy clients and a potential source of bias for therapists. If you’re a young therapist who reads this book and gets all these ideas about what “the paranoid patient” may do, you may project these assumptions onto every client you work with who struggles with paranoia or expresses thoughts that seem paranoid to you. Assumptions are not necessarily a bad thing–and may even be useful in some cases–but you need to be aware of them as you work. Thus far in my reading of this book, it has not provided any cautionary notes about making assumptions. Even in my classes, in which we are often told not to make assumptions, provide little if any guidance on learning to actually notice these assumptions in practice.

Shea also recommends a few other techniques that I find excessively presumptuous. Take this example dialogue from the book:

Pt.: After my wife left, it was like a star exploded inward, everything seemed so empty…she seemed like a memory and my life began to fall apart. Very shortly afterwards I began feeling very depressed and very tearful.

Clin.: It sounds terribly frightening to lose her so suddenly, so similar to the pain you felt when your mother died.

Pt.: No…no, that’s not right at all. My mother did not purposely abandon me. That’s simply not true.

Clin.: I did not mean that your mother purposely abandoned you, but rather that both people were unexpected loses.

Pt.: I suppose…but they were very different. I never was afraid of my mother…they’re really very different.

A lot of therapists, especially those in the psychodynamic tradition, are understandably attracted to the idea of making this sort of “insight.” As Shea points out, when you get it right, it can build a lot of trust because the client feels understood in a very special way. It feels good to feel “smart” and insightful, to be able to read people like that. It can remind us that there really is something special we can do as therapists that others cannot. It probably doesn’t hurt that this, the therapy-via-Sudden-Brilliant-Insight, is usually the only kind we see represented in the media.

But a lot of the time, there really isn’t enough information to reach this conclusion. Therapists may make these leaps based on hunches, but that doesn’t mean there’s data to back it up. Sometimes the client will tell you so, but I think that a lot of the time, they will say, “Hm, I suppose you might be right,” because you are an authority figure and they want to believe you have the answers.

From the information given, you can’t reasonably jump to the conclusion that the client felt similarly when their wife left them and when their mother died. Those are very different types of loss, and even similar types of loss–two breakups, two deaths in the family–can feel very different.

Certainly there can be conceptual similarities between losing a spouse to divorce and losing a parent to death. It might even be worthwhile to explore them, but the therapist need not assume they felt “so similar.” If I were the client, I would’ve liked the therapist to say something like:

Between this and your mother passing away, it sounds like you’ve been dealing with a lot of loss. I’m wondering if losing your wife is bringing up any memories of losing your mother.

This resonates with me; it might not with other clients. That’s why sometimes the more important thing as a therapist isn’t what you say, but how you respond once you realize you’ve said or done something that strains the connection between you and your client. In this case, a responsive therapist might say something like:

I’m sorry, I didn’t mean to make assumptions about how you’re feeling. Can you say a bit more about how this loss feels different for you?

The client is the expert on their experience.

But instance, in the dialogue, the therapist doubled down on the (mis)interpretation, attempting to justify their response to the client’s disclosure. This leads the client to double down as well, justifying to the therapist why the losses feel different. They shouldn’t have to justify themselves that way.

Here is the thought I had, as both a provider and a consumer of mental health services, when I read Shea’s example dialogue above:

Now, I don’t know if Shea is arrogant or presumptuous; I don’t know him but I would hope he isn’t. I do know that refusing to acknowledge missteps and misunderstandings can lead one to across that way, though. And that’s exactly what Shea refuses to do both in the dialogue itself and when he analyzes the dialogue for the reader:

Needless to say, this attempt at empathic connection leaves something to be desired. The patient’s attention to detail and fear of misunderstanding have obliterated the intended empathic message, leaving the clinician with a frustrating need to mollify a patient who has successfully twisted an empathic statement into an insult of sorts.

This probably infuriated me more than anything else in this text. Here, the failure of the interaction has been blamed entirely on the client. Shea has assumed that the client has taken his statement as an “insult” when there is no evidence of this; the client is merely correcting the therapist’s misinterpretation. It reminds me of how, often when I tell people they’ve made inaccurate assumptions about me, they respond by shrieking about how “upset” I am and how I take everything as an “insult.” Correcting someone is not the same thing as being “insulted.”

If this situation is “frustrating” for the clinician, then, I can only imagine how much more so it must be for the client.

There is no room, in this approach, for any acknowledgment that the therapist’s interpretations might simply be wrong. No room for the possibility that it’s not the client’s personal characteristics (“paranoid,” “guarded,” “histrionic”) that made this interaction fall flat, but the therapist’s presumptions and subsequent refusal to step back from them.

I discussed this particular example because it’s what came up in my reading, but it’s hardly the most egregious thing of this type that happens. Therapists who cannot conceive of the possibility that they’re wrong not only fail to help their clients, but can actually hurt them.

Since there are probably a lot more therapy clients (or prospective therapy clients) reading this than there are therapists, I want to be clear about why I wrote this. It’s not to discourage people from seeking therapy, but to arm them with the knowledge and language to advocate for what they need from their therapists, and to find therapists that suit their needs.

That last part is important. Some people may want a therapist who makes bold interpretations and takes that authoritative, explanatory sort of role. Personally, I think conducting therapy in this sort of way opens practitioners up to all sorts of bias and errors, which is one reason I want to avoid it both as a client and as a therapist. But if that’s the approach that resonates with you, then it’s likely to work a little better for you, because the most important factor is the client-therapist relationship.

Aside from that, the reason I write about problems in mental healthcare is the same reason I write about problems in feminism or atheism–to hold my own communities accountable. Anecdotally, I know that this sort of thing makes it difficult for some people to benefit from therapy, or even to want to access it to begin with. I’m not the only person who dislikes having an authority figure tell me things about my life without bothering to find out if their assumptions are even accurate.

Even if Bynes really did tell In Touch that she believes she has a microchip implanted in her brain that allows people to read her thoughts, that doesn’t mean it’s okay to call her “insane” or “crazy,” and I’m not surprised she’s angry about it. Words like that don’t just mean “displaying symptoms of a mental illness.” They connote ridicule, ignorance, and sometimes even hate.

They also place people with mental illnesses in a category apart from the rest of us, the ones who aren’t “crazy.” In fact, mental illnesses exist on a spectrum. Some people have a a few hallucinations or delusions during a time of extreme stress (or perhaps sleep deprivation). For others, psychotic symptoms are a struggle they must manage for their entire lives.

Are all of these people “crazy?” Is everyone who has ever had a random and totally irrational thought “crazy?” Is everyone who takes medication for anxiety, depression, or bipolar disorder “crazy?” Words like “crazy” and “insane” do not refer to any specific set or level of symptoms. They refer to someone we wish to hurt, ostracize, or laugh at.

How do you report a story like Bynes’ without perpetuating the stigma that people with mental illnesses face?

For starters, recognize that some things are newsworthy whether the person who did them is a celebrity or not; others are newsworthy only when they’re done by someone we’re already paying attention to—or used to pay attention to. People get DUIs and shoplift all the time, but when a famous person does it, that suddenly becomes a reason to write an entire news story. Someone having delusions is also not in and of itself interesting to the public—although, in a way, I wish it were, because maybe then people would know more about it and stigmatize those who struggle with it less.

Obviously, journalists have to make money. Sometimes that means writing stuff that sells, whether or not you personally think that this information is important to collect and provide to the public. However, oftentimes journalists—especially those who cover celeb news—shrug off all responsibility for choosing their subject matter by claiming that it’s “just what sells” or “what the people want.”